Your healthcare team may recommend medications as part of your obesity management plan, alongside behavioural changes. Before starting a new medication, your healthcare professional will discuss and consider a number of different factors such as your health history, BMI, other complications of obesity, such as type 2 diabetes or high blood pressure and possible side effects.
In Canada, three prescription medications are available for the treatment of overweight and obesity.
Contrave® (naltrexone and bupropion)
Contrave® combines low doses of naltrexone, a medication commonly used to manage alcohol and opioid dependency, and bupropion, an atypical antidepressant that’s also prescribed for smoking cessation. These medicines work on two separate areas of the brain that are involved in controlling eating (hunger and cravings). Contrave® is delivered in the form of an oral tablet; at the maximum recommended dose, two tablets are administered twice daily. In Canada, it is approved for use (alongside a reduced-calorie diet and increased physical activity) in adult patients with:
- A body mass index (BMI) of 30 kg/m2 or higher; or
- A BMI of 27 kg/m2 or above with the presence of at least one weight-related condition such as hypertension, type 2 diabetes or dyslipidemia (abnormal amounts of triglycerides, cholesterol or fat in the blood).
GLP-1 (or glucagon-like peptide-1) is a hormone that is found naturally in your body that has effects on appetite and food intake. Saxenda® is a GLP-1 therapy that is similar to the natural GLP-1 found in your body. Saxenda® is thought to help patients lose weight by decreasing appetite and the amount you eat. Studies with Saxenda® have also shown that it may also improve other health factors beyond weight, including waist circumference, blood sugar, blood pressure and cholesterol levels. Saxenda® comes in a prefilled pen that you can use to self-inject.
In Canada, Saxenda® is indicated along with a reduced-calorie diet and increased physical activity for chronic weight management in adult patients with an initial body mass index (BMI) of:
- 30 kg/m2 or greater, or
- 27 kg/m2 or greater in the presence of at least one weight-related comorbidity (e.g., hypertension, type 2 diabetes or dyslipidemia) and who have failed a previous weight management intervention.
In order for fats from foods you eat to be absorbed into the body, they need to be broken down by enzymes called lipases. When Xenical® is taken with meals, it prevents these enzymes from working and causes a decrease in the amount of fat your body absorbs from your food. When you absorb less fat, you take in fewer calories, leading to weight loss. Xenical® does not decrease or change your appetite. Studies with Xenical® have also shown that it may also improve other health factors beyond weight, including waist circumference, blood sugar, blood pressure and cholesterol levels. Xenical® is administered as a capsule during or just following each main meal.